1. Pain Relief Centre 165 Southpark Blvd St Augustine Florida 32086 Painreliefcentre.net

2. Dr. Scott Fechter Type of Physician: Chiropractor Special Focus: Chiropractic Rehabilitative Sports Medicine Education: Sherman College, Spartanburg, SC. Flagler College, St Augustine FL Year Established : 2002

3. Chiropractic Education Florida licensed chiropractors are required to have pre-medical education culminating in a Bachelors degree. The doctor of chiropractic medicine degree requires: 8 years that include pre-chiropractic medicine, basic and clinical sciences

4. Dr. Scott Fechter Professional Memberships: North American Spine Society (NASS), Florida Chiropractic Association (FCA), American Chiropractic Association (ACA), National Federation of Personal Trainers (NFPT), National Board of Chiropractic Examiners (NBCE) Parts I, II, III, IV, Spine Research Institute of San Diego

5. Dr. Scott Fechter Additional Information: A comprehensive approach to musculoskeletal injuries using: Chiropractic Care, Massage Therapy and Rehabilitative/Sports Medicine. Spine Research Institute of San Diego, Whiplash and Brain Injury Traumatology Graduate: 2010.

6. Arthritis Is a chronic disease and can affect people at any stage of life ARTHRITIS (From Greek) means “joint inflammation” A joint is the area where two bones meet Arthritis is inflammation of one or more joints When a joint is inflamed it may be swollen, tender, warm to the touch or red

7. Arthritis (continued) Arthritis involves the breakdown of cartilage. Cartilage normally protects a joint, allowing it to move smoothly. Cartilage also absorbs shock when pressure is placed on the joint, such as when you walk. Without the normal amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness. Symptoms differ depending on the arthritis. Some type of arthritis can affect major organs like the heart and lung

8. Type of Arthritis There are over 100 different forms of arthritis. Some of the most common forms are: 1. Osteoarthritis (degenerative joint disease) is a result of trauma to the joint, infection of the joint, or age. Osteoarthritis (OA) is the most common joint disorder, which is due to aging and wear and tear on a joint Often, the cause of OA is unknown. It is mainly related to aging. The symptoms of OA usually appear in middle age. Almost everyone has some symptoms by age 70. However, these symptoms may be minor. Before age 55, OA occurs equally in men and women. After age 55, it is more common in women. OA tends to run in families. Being overweight increases the risk of OA Fractures or other joint injuries can lead to OA later in life Playing sports has a direct impact on OA

9. Osteoarthritis Pain and stiffness in the joints are the most common symptoms. The pain is often worse after exercise and when you put weight or pressure on the joint. If you have osteoarthritis, your joints probably become stiffer and harder to move over time. You may notice a rubbing, grating, or crackling sound when you move the joint.

10. Osteoarthritis The phrase "morning stiffness" refers to the pain and stiffness you may feel when you first wake up in the morning. Stiffness usually lasts for 30 minutes or less. It is improved by mild activity that "warms up" the joint. During the day, the pain may get worse when you're active and feel better when you are resting. After a while, the pain may be present when you are resting. It may even wake you up at night.

11. Type of Arthritis 2. Rheumatoid Arthritis: It occurs as a result of the immune system causing inflammation. (autoimmune disease) It affects both wrists and both hands, symptoms include: commonly morning stiffness, poor grip strength RA can occur at any age, but is more common in middle age. Women get RA more often than men. Infection, genes, and hormone changes may be linked to the disease

12. . Rheumatoid Arthritis The areas of the hand commonly affected by rheumatoid arthritis

13. . Rheumatoid Arthritis (continued) Rheumatoid arthritis is usually symmetrical

14. Types of Arthritis (continued) 3. Juvenile rheumatoid arthritis: Juvenile rheumatoid arthritis (JRA) is a term used to describe a common type of arthritis in children. It is a long- term (chronic) disease resulting in joint pain and swelling. 4. Gout: Deposits of needle-like crystals of uric acid in the joints It affects toe, foot, ankle, knee etc 5. Infectious arthritis: Cause by infectious agents such as bacteria or viruses 6. Psoriatic arthritis: Often affects the joints at the ends of fingers and toes

15. Types of Arthritis (continued) Hip arthritis: A degenerative disease Caused due to the wear and tear of the cartilage which damages the joint. Causes of Arthritis: Age Weight Previous injury Systemic disease Infection

16. Osteoarthritis of the Knee Normal KneeOsteoarthritis

17. Osteoarthritis of Lumbar Spine Normal SpineOsteoarthritis

18. Osteoarthritis of the Hip Normal HipOsteoarthritis

19. Blood Tests: They can help diagnose arthritis and track disease activity Complete blood count(CBC) Automated machines rapidly count the cell types. WBC RBC Hemoglobin Platelets Differential WBC count Specialized tests: ESR(Erythrocyte sedimentation rate) RF (Rheumatoid Factor )

20. Diagnostics and Medications X rays and other Imaging procedures: X-rays provide an image of the bones MRI CT Medication: Basically 5 categories NSAIDs Analgesics(painkiller) Disease-modifying antirheumatic drugs (DMARDs)Corticosteroids Joint Surgery Options

21. Chiropractic Treatment C hiropractic medicine focuses on the relationship of the structural and neurological aspects of the body in health and disease. Its therapeutics utilize adjustive and manipulative procedures and physiological therapeutics, kinesiology and rehabilitative procedures to aid in restoration of anatomical relationships and physiologic capabilities.

22. Chiropractic Treatment Chiropractic treatment at the PRC focuses on maintaining and improving movement and mobility. At the PRC we can give you exercises that will help you to stay flexible and build up your muscle strength. We can also help you to improve your general level of fitness.

23. Common problems treated by chiropractic physicians Arthritis Neck and Low Back Pain Shoulder Pain Carpal Tunnel Syndrome Sports Injuries Automobile Accident Injuries Joint Pain Muscle Pain

24. Our Facility

25. VOTED BEST of Saint Augustine We Offer: Quality Chiropractic Care Physiotherapy Massage Therapy Affordable payment plans Insurance Assignment Preferred Provider Blue Cross of FL Preferred providers for Saint Johns County School Board